Department of Public Health, Shihezi University School of Medicine, Shihezi, China.
Xinjiang Uighur Autonomous Region Center for Disease Control and Prevention, Wulumuqi, China.
BMJ Open. 2021 Jun 28;11(6):e043155. doi: 10.1136/bmjopen-2020-043155.
The System of Health Accounts 2011 (SHA 2011) assists in health policy analysis and health expenditure comparison at the international level. Based on SHA 2011, this study analysed the distribution of beneficiary groups of curative care expenditure (CCE) in Xinjiang, to present suggestions for developing health policies.
A total of 160 health institutions were selected using the multistage stratified random sampling method. An analysis of the agewise CCE distribution, institutional flow, and disease distribution was then performed based on the SHA 2011 accounting framework.
In 2016, the CCE in Xinjiang was ¥50.05 billion, accounting for 70.18% of current health expenditure and 6.66% of the gross domestic product. The per capita CCE was ¥2366.56. The CCE was distributed differently across age groups, with the highest spending on people over the age of 65 years. The CCE was highest for diseases of the circulatory, respiratory and digestive systems. Most of the expenditure was incurred in hospitals and, to a lesser extent, in primary healthcare institutions. Family health expenditure, especially on children aged 14 years and below, accounted for a relatively high proportion of the CCE.
SHA 2011 was used to capture data, which was then analysed according to the newly added beneficiary dimension. The findings revealed that the use of medical resources is low, the scale of primary medical institutions needs to be significantly expanded and there is a need to optimise the CCE financing scheme. Therefore, the health policymaking department should optimise the relevant policies and improve the efficiency of health services.
《2011 年卫生核算体系》（SHA 2011）有助于在国际层面进行卫生政策分析和卫生支出比较。本研究基于 SHA 2011，分析了新疆医疗服务支出（CCE）受益人群的分布情况，为制定卫生政策提供建议。
采用多阶段分层随机抽样方法，共选取了 160 家卫生机构。然后，根据 SHA 2011 的核算框架，对年龄别 CCE 分布、机构流向和疾病分布进行分析。
2016 年，新疆 CCE 为 500.5 亿元，占当年卫生总费用的 70.18%，占国内生产总值的 6.66%。人均 CCE 为 2366.56 元。CCE 在不同年龄组之间的分布存在差异，65 岁以上人群的支出最高。支出最高的疾病类别为循环、呼吸和消化系统疾病。支出主要发生在医院，其次是基层医疗机构。家庭卫生支出，尤其是 14 岁及以下儿童的卫生支出，占 CCE 的相对较高比例。
使用 SHA 2011 捕获数据，并根据新增加的受益人群维度进行分析。研究结果表明，医疗资源利用效率较低，基层医疗机构规模有待显著扩大，需要优化 CCE 筹资方案。因此，卫生决策部门应优化相关政策，提高卫生服务效率。
